MEDICARE: DANIEL ANTONIO BARRON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1396041257
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIEL ANTONIO BARRON

Provider Business Mailing Address
First Line	:	66 HURLBUT ST
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91105-4025
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4611 LA MIRADA AVE
Second Line	:	31
City	:	LOS ANGELES
State	:	CA
Zip	:	90029-1851
Country	:	US
Telephone Number	:	415-302-4048
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2011
Last Update Date	:	02/09/2011

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